Temporal Trends in the Population Structure ofBordetella pertussisduring 1949–1996 in a Highly Vaccinated Population

Abstract

The population structure of Bordetella pertussis in The Netherlands in 5 successive periods, encompassing 1949-1996, was analyzed by DNA typing ("fingerprinting"). In 10 years following the introduction of wide-scale vaccination in 1953, a decrease in genotypic diversity (GD) was observed, suggesting clonal expansion of strains that were adapted to vaccine-induced immunity. In subsequent periods, GD increased to prevaccination levels, probably reflecting a gradual adaptation of the B. pertussis population involving many lineages. In the 1990s, GD decreased again. This decrease coincided with an antigenic shift in the surface protein pertactin. No evidence was found for changes in DNA types or GD in 1996, when a large pertussis epidemic occurred. Thus, gradual changes in the bacterial population previous to 1996 were probably the cause of the 1996 epidemic. The results herein suggest that vaccination has selected for strains that are adapted to a highly vaccinated population. Similar changes may have occurred in other countries, explaining the reemergence of pertussis in vaccinated populations.

The diagnosis and management of chronic cough

“…Pertussis causes cough for many months and does not respond to treatment. Recently, an epidemic increase of pertussis has been reported in vaccinated children, possibly as a result of immunisation-driven emergence of polymorphisms of the surface protein pertactin, making the microorganisms less susceptible to vaccination-induced immunity [89,90]. Tuberculosis may cause chronic cough due to airways obstruction by protruding or perforating lymph nodes, and secondary infection of obstructed lung segments.…”

Adaptation ofBordetella pertussisto Vaccination: A Cause for Its Reemergence?

“…To investigate this hypothesis, B. pertussis strains collected in The Netherlands from 1949 to 1996 were characterized by DNA fingerprinting and sequencing of genes coding for surface proteins (8,9). Initially, we studied changes in the B. pertussis population by IS1002-based DNA fingerprinting (9,10). Strains collected from 1949 to 1996 were stratified in periods of 5 to 8 years, and the frequency of fingerprint types in each period was determined ( Figure 2).…”

Comparison of the Bordetella pertussis and Bordetella parapertussis Isolates Circulating in Saint Petersburg between 1998 and 2000 with Russian Vaccine Strains

“…Little heterogeneity has been detected within these species so far, although the isolates that were circulating during the prevaccine era differ from those that are circulating currently (7,9,13,16,22,23). Differences in strains can be detected by typing techniques such as pulsed-field gel electrophoresis (PFGE) and by sequencing the structural genes encoding B. pertussis virulence factors.…”